A case of Hypertensive Encephalopathy after cesarean section / 대한산부인과학회지

Hypertensive encephalopathy is usually defined as malignant hypertension associated with central nervous system abnormalities such as headache, seizure, hypertension, altered consciousness, increased intracranial pressure, and retinopathy. The pathogenesis of hypertensive encephalopathy is uncompletely understood, although it seems to be related to hypertensive cerebrovascular endothelial dysfunction, disruption of the blood-brain barrier with increased permeability, cerebral edema, and microhemorrhage formation. Magnetic resonance imaging shows a characteristic posterior leukoencephalopathy that predominantly affects the white matter of the parieto-occipital regions. Hypertensive encephalopathy is a rare manifestation of hypertensive emergency that requires proper diagnosis and management to avoid a irreversible brain damage. We report a patient who developed hypertensive encephalopathy after cesarean section without preeclampsia or chronic hypertension and a case presented with a brief review of the literatures.

Comparison of Hospital stay and Cost-effectiveness between Treatment Modalities in Ectopic Pregnancy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare the hospital stay and cost-effectiveness between treatment modalities in ectopic pregnancy for proper management. METHODS: In this study, the authors studied 121 cases retrospectively who had been admitted and treated at Department of Obstetrics and Gynecology, Konyang University Hospital from February 1, 2000 to August 31, 2003. We analyzed clinical features, treatment modality, hospital stay and cost-effectiveness between each groups. One-way ANOVA test was used and p<0.05 was regarded as statistically significant. RESULTS: There was no difference in clinical features between treatment modalites. Of total 121 cases, operative procedures were done in 105 cases (explo-laparotomy in 58, laparoscopy in 43, dilatation and curettage in 4) and medical treatment in 16 cases (Multiple dose methotrexate protocol in 11, Single dose methotrexate protocol in 5). Average of length of hospital stay was 5.3 +/- 0.2 days in explo-laparotomy, 3.8 +/- 0.2 days in laparoscopy, 2.8 +/- 1.4 days in dilatation and curettage, 6.5 +/- 0.5 days in multiple dose methotrexate protocol, 2.4 +/- 0.4 days in single dose methotrexate protocol. According to treatment modality, there was significant difference in total cost and cost sharing. Total cost in explo-laparotomy (875,324 +/- 25,977 Won) was more expensive than that of laparoscopy (734,375 +/- 35,179 Won). But, cost sharing in explo-laparotomy (156,543 +/- 9,583 Won) was less expensive than laparoscopy (319,493 +/- 26,255 Won). Total cost and cost sharing in multiple dose methotrexate protocol (323,231 +/- 33,972 Won, 184,465 +/- 17,344 Won) was more expensive than that of Single methotrexate protocol (192,495 +/- 31,180 Won, 68,793 +/- 13,422 Won). CONCLUSION: Based on these results, it is very important that we should have an interest in ectopic pregnancy for early detection and proper management. Consequently, Achievement of precise decision and successful methotrexate treatment can be possible to decrease hospital stay and cost-effectiveness.